|
HC EXTENSION KIT
|
Facility
|
OP
|
$2,031.98
|
|
|
Service Code
|
HCPCS C1883
|
| Hospital Charge Code |
27800052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$751.83 |
| Max. Negotiated Rate |
$1,828.78 |
| Rate for Payer: Aetna American Axle |
$1,320.79
|
| Rate for Payer: Aetna Commercial |
$1,727.18
|
| Rate for Payer: Aetna Medicare |
$1,015.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,320.79
|
| Rate for Payer: BCBS Complete |
$812.79
|
| Rate for Payer: Cash Price |
$1,625.58
|
| Rate for Payer: Cofinity Commercial |
$1,422.39
|
| Rate for Payer: Cofinity Commercial |
$1,747.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,422.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,625.58
|
| Rate for Payer: Healthscope Commercial |
$1,828.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,422.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,523.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,727.18
|
| Rate for Payer: PHP Commercial |
$1,727.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.79
|
| Rate for Payer: Priority Health SBD |
$1,280.15
|
| Rate for Payer: UMR Bronson Commercial |
$751.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,523.98
|
|
|
HC EXTENSION KIT
|
Facility
|
IP
|
$2,031.98
|
|
|
Service Code
|
HCPCS C1883
|
| Hospital Charge Code |
27800052
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$894.07 |
| Max. Negotiated Rate |
$1,828.78 |
| Rate for Payer: Aetna American Axle |
$1,320.79
|
| Rate for Payer: Aetna Commercial |
$1,727.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,320.79
|
| Rate for Payer: Cash Price |
$1,625.58
|
| Rate for Payer: Cofinity Commercial |
$1,422.39
|
| Rate for Payer: Cofinity Commercial |
$1,747.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,422.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,625.58
|
| Rate for Payer: Healthscope Commercial |
$1,828.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,422.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,523.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,727.18
|
| Rate for Payer: PHP Commercial |
$1,727.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,320.79
|
| Rate for Payer: Priority Health SBD |
$1,280.15
|
| Rate for Payer: UMR Bronson Commercial |
$894.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,523.98
|
|
|
HC EXTENSION ST JUDE
|
Facility
|
IP
|
$2,370.66
|
|
|
Service Code
|
HCPCS C1883
|
| Hospital Charge Code |
27800053
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,043.09 |
| Max. Negotiated Rate |
$2,133.59 |
| Rate for Payer: Aetna American Axle |
$1,540.93
|
| Rate for Payer: Aetna Commercial |
$2,015.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,540.93
|
| Rate for Payer: Cash Price |
$1,896.53
|
| Rate for Payer: Cofinity Commercial |
$1,659.46
|
| Rate for Payer: Cofinity Commercial |
$2,038.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,659.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,896.53
|
| Rate for Payer: Healthscope Commercial |
$2,133.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,659.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,778.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,015.06
|
| Rate for Payer: PHP Commercial |
$2,015.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,540.93
|
| Rate for Payer: Priority Health SBD |
$1,493.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,043.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,778.00
|
|
|
HC EXTENSION ST JUDE
|
Facility
|
OP
|
$2,370.66
|
|
|
Service Code
|
HCPCS C1883
|
| Hospital Charge Code |
27800053
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$877.14 |
| Max. Negotiated Rate |
$2,133.59 |
| Rate for Payer: Aetna American Axle |
$1,540.93
|
| Rate for Payer: Aetna Commercial |
$2,015.06
|
| Rate for Payer: Aetna Medicare |
$1,185.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,540.93
|
| Rate for Payer: BCBS Complete |
$948.26
|
| Rate for Payer: Cash Price |
$1,896.53
|
| Rate for Payer: Cofinity Commercial |
$1,659.46
|
| Rate for Payer: Cofinity Commercial |
$2,038.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,659.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,896.53
|
| Rate for Payer: Healthscope Commercial |
$2,133.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,659.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,778.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,015.06
|
| Rate for Payer: PHP Commercial |
$2,015.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,540.93
|
| Rate for Payer: Priority Health SBD |
$1,493.52
|
| Rate for Payer: UMR Bronson Commercial |
$877.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,778.00
|
|
|
HC EXTERNAL EKG RECORDIN >48 HRS UP TO 7 DAYS
|
Facility
|
IP
|
$91.13
|
|
|
Service Code
|
CPT 93242
|
| Hospital Charge Code |
48000030
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$40.10 |
| Max. Negotiated Rate |
$82.02 |
| Rate for Payer: Aetna American Axle |
$59.23
|
| Rate for Payer: Aetna Commercial |
$77.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.23
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Cofinity Commercial |
$63.79
|
| Rate for Payer: Cofinity Commercial |
$78.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$63.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.90
|
| Rate for Payer: Healthscope Commercial |
$82.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.46
|
| Rate for Payer: PHP Commercial |
$77.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.23
|
| Rate for Payer: Priority Health SBD |
$57.41
|
| Rate for Payer: UMR Bronson Commercial |
$40.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.35
|
|
|
HC EXTERNAL EKG RECORDIN >48 HRS UP TO 7 DAYS
|
Facility
|
OP
|
$91.13
|
|
|
Service Code
|
CPT 93242
|
| Hospital Charge Code |
48000030
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$10.82 |
| Max. Negotiated Rate |
$816.00 |
| Rate for Payer: Aetna American Axle |
$59.23
|
| Rate for Payer: Aetna Commercial |
$77.46
|
| Rate for Payer: Aetna Medicare |
$40.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.08
|
| Rate for Payer: BCBS Complete |
$21.65
|
| Rate for Payer: BCBS MAPPO |
$38.46
|
| Rate for Payer: BCBS Trust/PPO |
$38.90
|
| Rate for Payer: BCN Commercial |
$38.90
|
| Rate for Payer: BCN Medicare Advantage |
$38.46
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Cash Price |
$72.90
|
| Rate for Payer: Cofinity Commercial |
$63.79
|
| Rate for Payer: Cofinity Commercial |
$78.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$63.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.46
|
| Rate for Payer: Healthscope Commercial |
$82.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.35
|
| Rate for Payer: Mclaren Medicaid |
$20.61
|
| Rate for Payer: Mclaren Medicare |
$38.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.38
|
| Rate for Payer: Meridian Medicaid |
$21.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.46
|
| Rate for Payer: Nomi Health Commercial |
$115.38
|
| Rate for Payer: PACE Medicare |
$36.54
|
| Rate for Payer: PACE SWMI |
$38.46
|
| Rate for Payer: PHP Commercial |
$77.46
|
| Rate for Payer: PHP Medicare Advantage |
$38.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.87
|
| Rate for Payer: Priority Health Medicare |
$38.46
|
| Rate for Payer: Priority Health Narrow Network |
$96.70
|
| Rate for Payer: Priority Health SBD |
$57.41
|
| Rate for Payer: Railroad Medicare Medicare |
$38.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.90
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.46
|
| Rate for Payer: UHC Exchange |
$10.82
|
| Rate for Payer: UHC Medicare Advantage |
$38.46
|
| Rate for Payer: UHCCP Medicaid |
$20.61
|
| Rate for Payer: UMR Bronson Commercial |
$33.72
|
| Rate for Payer: VA VA |
$38.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.35
|
|
|
HC EXTERNAL EKG RECORDING >7 DAYS UP TO 15 DAYS
|
Facility
|
OP
|
$137.39
|
|
|
Service Code
|
CPT 93246
|
| Hospital Charge Code |
48000031
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$10.82 |
| Max. Negotiated Rate |
$816.00 |
| Rate for Payer: Aetna American Axle |
$89.30
|
| Rate for Payer: Aetna Commercial |
$116.78
|
| Rate for Payer: Aetna Medicare |
$40.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.08
|
| Rate for Payer: BCBS Complete |
$21.65
|
| Rate for Payer: BCBS MAPPO |
$38.46
|
| Rate for Payer: BCBS Trust/PPO |
$38.90
|
| Rate for Payer: BCN Commercial |
$38.90
|
| Rate for Payer: BCN Medicare Advantage |
$38.46
|
| Rate for Payer: Cash Price |
$109.91
|
| Rate for Payer: Cash Price |
$109.91
|
| Rate for Payer: Cash Price |
$109.91
|
| Rate for Payer: Cofinity Commercial |
$118.16
|
| Rate for Payer: Cofinity Commercial |
$96.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$96.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.46
|
| Rate for Payer: Healthscope Commercial |
$123.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.04
|
| Rate for Payer: Mclaren Medicaid |
$20.61
|
| Rate for Payer: Mclaren Medicare |
$38.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.38
|
| Rate for Payer: Meridian Medicaid |
$21.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.78
|
| Rate for Payer: Nomi Health Commercial |
$115.38
|
| Rate for Payer: PACE Medicare |
$36.54
|
| Rate for Payer: PACE SWMI |
$38.46
|
| Rate for Payer: PHP Commercial |
$116.78
|
| Rate for Payer: PHP Medicare Advantage |
$38.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.87
|
| Rate for Payer: Priority Health Medicare |
$38.46
|
| Rate for Payer: Priority Health Narrow Network |
$96.70
|
| Rate for Payer: Priority Health SBD |
$86.56
|
| Rate for Payer: Railroad Medicare Medicare |
$38.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.90
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.46
|
| Rate for Payer: UHC Exchange |
$10.82
|
| Rate for Payer: UHC Medicare Advantage |
$38.46
|
| Rate for Payer: UHCCP Medicaid |
$20.61
|
| Rate for Payer: UMR Bronson Commercial |
$50.83
|
| Rate for Payer: VA VA |
$38.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.04
|
|
|
HC EXTERNAL EKG RECORDING >7 DAYS UP TO 15 DAYS
|
Facility
|
IP
|
$137.39
|
|
|
Service Code
|
CPT 93246
|
| Hospital Charge Code |
48000031
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$60.45 |
| Max. Negotiated Rate |
$123.65 |
| Rate for Payer: Aetna American Axle |
$89.30
|
| Rate for Payer: Aetna Commercial |
$116.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.30
|
| Rate for Payer: Cash Price |
$109.91
|
| Rate for Payer: Cofinity Commercial |
$118.16
|
| Rate for Payer: Cofinity Commercial |
$96.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$96.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.91
|
| Rate for Payer: Healthscope Commercial |
$123.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.78
|
| Rate for Payer: PHP Commercial |
$116.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.30
|
| Rate for Payer: Priority Health SBD |
$86.56
|
| Rate for Payer: UMR Bronson Commercial |
$60.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.04
|
|
|
HC EXTERNAL PACER
|
Facility
|
IP
|
$576.43
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
48000001
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$253.63 |
| Max. Negotiated Rate |
$518.79 |
| Rate for Payer: Aetna American Axle |
$374.68
|
| Rate for Payer: Aetna Commercial |
$489.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.68
|
| Rate for Payer: Cash Price |
$461.14
|
| Rate for Payer: Cofinity Commercial |
$403.50
|
| Rate for Payer: Cofinity Commercial |
$495.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$403.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.14
|
| Rate for Payer: Healthscope Commercial |
$518.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$403.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.97
|
| Rate for Payer: PHP Commercial |
$489.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.68
|
| Rate for Payer: Priority Health SBD |
$363.15
|
| Rate for Payer: UMR Bronson Commercial |
$253.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.32
|
|
|
HC EXTERNAL PACER
|
Facility
|
OP
|
$576.43
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
48000001
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.01 |
| Max. Negotiated Rate |
$2,015.13 |
| Rate for Payer: Aetna American Axle |
$374.68
|
| Rate for Payer: Aetna Commercial |
$489.97
|
| Rate for Payer: Aetna Medicare |
$666.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$801.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$801.44
|
| Rate for Payer: BCBS Complete |
$360.84
|
| Rate for Payer: BCBS MAPPO |
$641.15
|
| Rate for Payer: BCBS Trust/PPO |
$1.40
|
| Rate for Payer: BCN Commercial |
$1.40
|
| Rate for Payer: BCN Medicare Advantage |
$641.15
|
| Rate for Payer: Cash Price |
$461.14
|
| Rate for Payer: Cash Price |
$461.14
|
| Rate for Payer: Cash Price |
$461.14
|
| Rate for Payer: Cofinity Commercial |
$403.50
|
| Rate for Payer: Cofinity Commercial |
$495.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$403.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$461.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$641.15
|
| Rate for Payer: Healthscope Commercial |
$518.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$403.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$432.32
|
| Rate for Payer: Mclaren Medicaid |
$343.66
|
| Rate for Payer: Mclaren Medicare |
$641.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$673.21
|
| Rate for Payer: Meridian Medicaid |
$360.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$737.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$489.97
|
| Rate for Payer: Nomi Health Commercial |
$1,923.45
|
| Rate for Payer: PACE Medicare |
$609.09
|
| Rate for Payer: PACE SWMI |
$641.15
|
| Rate for Payer: PHP Commercial |
$489.97
|
| Rate for Payer: PHP Medicare Advantage |
$641.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,015.13
|
| Rate for Payer: Priority Health Medicare |
$641.15
|
| Rate for Payer: Priority Health Narrow Network |
$1,612.10
|
| Rate for Payer: Priority Health SBD |
$363.15
|
| Rate for Payer: Railroad Medicare Medicare |
$641.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.11
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$641.15
|
| Rate for Payer: UHC Exchange |
$1.01
|
| Rate for Payer: UHC Medicare Advantage |
$641.15
|
| Rate for Payer: UHCCP Medicaid |
$343.66
|
| Rate for Payer: UMR Bronson Commercial |
$213.28
|
| Rate for Payer: VA VA |
$641.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$432.32
|
|
|
HC EXTERNAL VERSION
|
Facility
|
OP
|
$2,838.32
|
|
|
Service Code
|
CPT 59412
|
| Hospital Charge Code |
36100121
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$101.62 |
| Max. Negotiated Rate |
$9,791.14 |
| Rate for Payer: Aetna American Axle |
$1,844.91
|
| Rate for Payer: Aetna Commercial |
$2,412.57
|
| Rate for Payer: Aetna Medicare |
$3,239.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,844.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,894.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,894.05
|
| Rate for Payer: BCBS Complete |
$1,753.26
|
| Rate for Payer: BCBS MAPPO |
$3,115.24
|
| Rate for Payer: BCBS Trust/PPO |
$809.02
|
| Rate for Payer: BCN Commercial |
$809.02
|
| Rate for Payer: BCN Medicare Advantage |
$3,115.24
|
| Rate for Payer: Cash Price |
$2,270.66
|
| Rate for Payer: Cash Price |
$2,270.66
|
| Rate for Payer: Cash Price |
$2,270.66
|
| Rate for Payer: Cofinity Commercial |
$2,440.96
|
| Rate for Payer: Cofinity Commercial |
$1,986.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,986.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,270.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,115.24
|
| Rate for Payer: Healthscope Commercial |
$2,554.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,986.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,128.74
|
| Rate for Payer: Mclaren Medicaid |
$1,669.77
|
| Rate for Payer: Mclaren Medicare |
$3,115.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,271.00
|
| Rate for Payer: Meridian Medicaid |
$1,753.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,582.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,412.57
|
| Rate for Payer: Nomi Health Commercial |
$6,542.00
|
| Rate for Payer: PACE Medicare |
$2,959.48
|
| Rate for Payer: PACE SWMI |
$3,115.24
|
| Rate for Payer: PHP Commercial |
$2,412.57
|
| Rate for Payer: PHP Medicare Advantage |
$3,115.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,669.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,791.14
|
| Rate for Payer: Priority Health Medicare |
$3,115.24
|
| Rate for Payer: Priority Health Narrow Network |
$7,832.91
|
| Rate for Payer: Priority Health SBD |
$1,788.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3,115.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.78
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,115.24
|
| Rate for Payer: UHC Exchange |
$101.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,115.24
|
| Rate for Payer: UHCCP Medicaid |
$1,669.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,050.18
|
| Rate for Payer: VA VA |
$3,115.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,128.74
|
|
|
HC EXTERNAL VERSION
|
Facility
|
IP
|
$2,838.32
|
|
|
Service Code
|
CPT 59412
|
| Hospital Charge Code |
36100121
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,248.86 |
| Max. Negotiated Rate |
$2,554.49 |
| Rate for Payer: Aetna American Axle |
$1,844.91
|
| Rate for Payer: Aetna Commercial |
$2,412.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,844.91
|
| Rate for Payer: Cash Price |
$2,270.66
|
| Rate for Payer: Cofinity Commercial |
$1,986.82
|
| Rate for Payer: Cofinity Commercial |
$2,440.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,986.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,270.66
|
| Rate for Payer: Healthscope Commercial |
$2,554.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,986.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,128.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,412.57
|
| Rate for Payer: PHP Commercial |
$2,412.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,844.91
|
| Rate for Payer: Priority Health SBD |
$1,788.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,248.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,128.74
|
|
|
HC EXTRAORAL INC AND DRAIN ABSC, CYST, HEMATOMA FLOOR OF MOUTH SUBLING
|
Facility
|
OP
|
$390.69
|
|
|
Service Code
|
CPT 41015
|
| Hospital Charge Code |
76100137
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.56 |
| Max. Negotiated Rate |
$1,568.21 |
| Rate for Payer: Aetna American Axle |
$253.95
|
| Rate for Payer: Aetna Commercial |
$332.09
|
| Rate for Payer: Aetna Medicare |
$518.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.69
|
| Rate for Payer: BCBS Complete |
$280.81
|
| Rate for Payer: BCBS MAPPO |
$498.95
|
| Rate for Payer: BCBS Trust/PPO |
$372.53
|
| Rate for Payer: BCN Commercial |
$372.53
|
| Rate for Payer: BCN Medicare Advantage |
$498.95
|
| Rate for Payer: Cash Price |
$312.55
|
| Rate for Payer: Cash Price |
$312.55
|
| Rate for Payer: Cash Price |
$312.55
|
| Rate for Payer: Cofinity Commercial |
$335.99
|
| Rate for Payer: Cofinity Commercial |
$273.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$273.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.95
|
| Rate for Payer: Healthscope Commercial |
$351.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$273.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$293.02
|
| Rate for Payer: Mclaren Medicaid |
$267.44
|
| Rate for Payer: Mclaren Medicare |
$498.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.90
|
| Rate for Payer: Meridian Medicaid |
$280.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.09
|
| Rate for Payer: Nomi Health Commercial |
$1,047.80
|
| Rate for Payer: PACE Medicare |
$474.00
|
| Rate for Payer: PACE SWMI |
$498.95
|
| Rate for Payer: PHP Commercial |
$332.09
|
| Rate for Payer: PHP Medicare Advantage |
$498.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,568.21
|
| Rate for Payer: Priority Health Medicare |
$498.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,254.57
|
| Rate for Payer: Priority Health SBD |
$246.13
|
| Rate for Payer: Railroad Medicare Medicare |
$498.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.51
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.95
|
| Rate for Payer: UHC Exchange |
$283.19
|
| Rate for Payer: UHC Medicare Advantage |
$498.95
|
| Rate for Payer: UHCCP Medicaid |
$267.44
|
| Rate for Payer: UMR Bronson Commercial |
$144.56
|
| Rate for Payer: VA VA |
$498.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$293.02
|
|
|
HC EXTRAORAL INC AND DRAIN ABSC, CYST, HEMATOMA FLOOR OF MOUTH SUBLING
|
Facility
|
IP
|
$390.69
|
|
|
Service Code
|
CPT 41015
|
| Hospital Charge Code |
76100137
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$171.90 |
| Max. Negotiated Rate |
$351.62 |
| Rate for Payer: Aetna American Axle |
$253.95
|
| Rate for Payer: Aetna Commercial |
$332.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.95
|
| Rate for Payer: Cash Price |
$312.55
|
| Rate for Payer: Cofinity Commercial |
$273.48
|
| Rate for Payer: Cofinity Commercial |
$335.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$273.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.55
|
| Rate for Payer: Healthscope Commercial |
$351.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$273.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$293.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$332.09
|
| Rate for Payer: PHP Commercial |
$332.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.95
|
| Rate for Payer: Priority Health SBD |
$246.13
|
| Rate for Payer: UMR Bronson Commercial |
$171.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$293.02
|
|
|
HC EZPAP SUPPLY
|
Facility
|
OP
|
$127.99
|
|
| Hospital Charge Code |
27000072
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$47.36 |
| Max. Negotiated Rate |
$115.19 |
| Rate for Payer: Cofinity Commercial |
$89.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$89.59
|
| Rate for Payer: Aetna American Axle |
$83.19
|
| Rate for Payer: Aetna Commercial |
$108.79
|
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.19
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: Cash Price |
$102.39
|
| Rate for Payer: Cofinity Commercial |
$110.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.39
|
| Rate for Payer: Healthscope Commercial |
$115.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.79
|
| Rate for Payer: PHP Commercial |
$108.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.19
|
| Rate for Payer: Priority Health SBD |
$80.63
|
| Rate for Payer: UMR Bronson Commercial |
$47.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.99
|
|
|
HC EZPAP SUPPLY
|
Facility
|
IP
|
$127.99
|
|
| Hospital Charge Code |
27000072
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$56.32 |
| Max. Negotiated Rate |
$115.19 |
| Rate for Payer: Aetna American Axle |
$83.19
|
| Rate for Payer: Aetna Commercial |
$108.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.19
|
| Rate for Payer: Cash Price |
$102.39
|
| Rate for Payer: Cofinity Commercial |
$110.07
|
| Rate for Payer: Cofinity Commercial |
$89.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$89.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.39
|
| Rate for Payer: Healthscope Commercial |
$115.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.79
|
| Rate for Payer: PHP Commercial |
$108.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.19
|
| Rate for Payer: Priority Health SBD |
$80.63
|
| Rate for Payer: UMR Bronson Commercial |
$56.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.99
|
|
|
HC F-18 SODIUM FLUORIDE <=30MCI
|
Facility
|
IP
|
$484.74
|
|
|
Service Code
|
HCPCS A9580
|
| Hospital Charge Code |
34300028
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$213.29 |
| Max. Negotiated Rate |
$436.27 |
| Rate for Payer: Aetna American Axle |
$315.08
|
| Rate for Payer: Aetna Commercial |
$412.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.08
|
| Rate for Payer: Cash Price |
$387.79
|
| Rate for Payer: Cofinity Commercial |
$339.32
|
| Rate for Payer: Cofinity Commercial |
$416.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$339.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.79
|
| Rate for Payer: Healthscope Commercial |
$436.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$339.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$412.03
|
| Rate for Payer: PHP Commercial |
$412.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.08
|
| Rate for Payer: Priority Health SBD |
$305.39
|
| Rate for Payer: UMR Bronson Commercial |
$213.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.56
|
|
|
HC F-18 SODIUM FLUORIDE <=30MCI
|
Facility
|
OP
|
$484.74
|
|
|
Service Code
|
HCPCS A9580
|
| Hospital Charge Code |
34300028
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$179.35 |
| Max. Negotiated Rate |
$720.66 |
| Rate for Payer: Aetna American Axle |
$315.08
|
| Rate for Payer: Aetna Commercial |
$412.03
|
| Rate for Payer: Aetna Medicare |
$242.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.08
|
| Rate for Payer: BCBS Complete |
$193.90
|
| Rate for Payer: BCBS Trust/PPO |
$720.66
|
| Rate for Payer: BCN Commercial |
$720.66
|
| Rate for Payer: Cash Price |
$387.79
|
| Rate for Payer: Cash Price |
$387.79
|
| Rate for Payer: Cofinity Commercial |
$339.32
|
| Rate for Payer: Cofinity Commercial |
$416.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$339.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$387.79
|
| Rate for Payer: Healthscope Commercial |
$436.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$339.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$363.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$412.03
|
| Rate for Payer: PHP Commercial |
$412.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.08
|
| Rate for Payer: Priority Health SBD |
$305.39
|
| Rate for Payer: UMR Bronson Commercial |
$179.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$363.56
|
|
|
HC F232 OVALBUMIN
|
Facility
|
IP
|
$29.33
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200439
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$26.40 |
| Rate for Payer: Aetna American Axle |
$19.06
|
| Rate for Payer: Aetna Commercial |
$24.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.06
|
| Rate for Payer: Cash Price |
$23.46
|
| Rate for Payer: Cofinity Commercial |
$20.53
|
| Rate for Payer: Cofinity Commercial |
$25.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.46
|
| Rate for Payer: Healthscope Commercial |
$26.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.93
|
| Rate for Payer: PHP Commercial |
$24.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.06
|
| Rate for Payer: Priority Health SBD |
$18.48
|
| Rate for Payer: UMR Bronson Commercial |
$12.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.00
|
|
|
HC F232 OVALBUMIN
|
Facility
|
OP
|
$29.33
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200439
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$26.90 |
| Rate for Payer: Aetna American Axle |
$19.06
|
| Rate for Payer: Aetna Commercial |
$24.93
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$17.28
|
| Rate for Payer: BCN Commercial |
$17.28
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$23.46
|
| Rate for Payer: Cash Price |
$23.46
|
| Rate for Payer: Cofinity Commercial |
$25.22
|
| Rate for Payer: Cofinity Commercial |
$20.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$26.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.00
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.93
|
| Rate for Payer: Nomi Health Commercial |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$24.93
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$14.34
|
| Rate for Payer: Priority Health SBD |
$18.48
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$10.85
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.00
|
|
|
HC F233 OVOMUCOID
|
Facility
|
IP
|
$29.33
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200440
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$26.40 |
| Rate for Payer: Aetna American Axle |
$19.06
|
| Rate for Payer: Aetna Commercial |
$24.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.06
|
| Rate for Payer: Cash Price |
$23.46
|
| Rate for Payer: Cofinity Commercial |
$20.53
|
| Rate for Payer: Cofinity Commercial |
$25.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.46
|
| Rate for Payer: Healthscope Commercial |
$26.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.93
|
| Rate for Payer: PHP Commercial |
$24.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.06
|
| Rate for Payer: Priority Health SBD |
$18.48
|
| Rate for Payer: UMR Bronson Commercial |
$12.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.00
|
|
|
HC F233 OVOMUCOID
|
Facility
|
OP
|
$29.33
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200440
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$26.90 |
| Rate for Payer: Aetna American Axle |
$19.06
|
| Rate for Payer: Aetna Commercial |
$24.93
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$17.28
|
| Rate for Payer: BCN Commercial |
$17.28
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$23.46
|
| Rate for Payer: Cash Price |
$23.46
|
| Rate for Payer: Cofinity Commercial |
$25.22
|
| Rate for Payer: Cofinity Commercial |
$20.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$26.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.00
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.93
|
| Rate for Payer: Nomi Health Commercial |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$24.93
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$14.34
|
| Rate for Payer: Priority Health SBD |
$18.48
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$10.85
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.00
|
|
|
HC F352 RARA H8 PR-10 PEANUT
|
Facility
|
IP
|
$31.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200450
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.86 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna American Axle |
$20.47
|
| Rate for Payer: Aetna Commercial |
$26.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.47
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$22.04
|
| Rate for Payer: Cofinity Commercial |
$27.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.19
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.77
|
| Rate for Payer: PHP Commercial |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.47
|
| Rate for Payer: Priority Health SBD |
$19.84
|
| Rate for Payer: UMR Bronson Commercial |
$13.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
HC F352 RARA H8 PR-10 PEANUT
|
Facility
|
OP
|
$31.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200450
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna American Axle |
$20.47
|
| Rate for Payer: Aetna Commercial |
$26.77
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$17.28
|
| Rate for Payer: BCN Commercial |
$17.28
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$27.08
|
| Rate for Payer: Cofinity Commercial |
$22.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.77
|
| Rate for Payer: Nomi Health Commercial |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$26.77
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$14.34
|
| Rate for Payer: Priority Health SBD |
$19.84
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$11.65
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
|
HC F422 RARA H1 PEANUT
|
Facility
|
OP
|
$31.49
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200446
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$28.34 |
| Rate for Payer: Aetna American Axle |
$20.47
|
| Rate for Payer: Aetna Commercial |
$26.77
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$17.28
|
| Rate for Payer: BCN Commercial |
$17.28
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cash Price |
$25.19
|
| Rate for Payer: Cofinity Commercial |
$27.08
|
| Rate for Payer: Cofinity Commercial |
$22.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$28.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.62
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.77
|
| Rate for Payer: Nomi Health Commercial |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$26.77
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$14.34
|
| Rate for Payer: Priority Health SBD |
$19.84
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$11.65
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.62
|
|
